Subjects were recruited from a single centre. Bronchial biopsy remodelling features that were the strongest predictors of lung function impairment and QCT-derived proximal airway morphometry and air trapping markers were determined by stepwise multiple regression. The best predictor of air trapping was validated in an independent replication group.

Airway smooth muscle % was the only predictor of post-bronchodilator forced expiratory volume in 1 s (FEV1) % pred, while both airway smooth muscle % and vascularity were predictors of FEV1/forced vital capacity. Epithelial thickness and airway smooth muscle % were predictors of mean segmental bronchial luminal area (R2=0.12; p=0.02 and R2=0.12; p=0.015), whereas epithelial thickness was the only predictor of wall area % (R2=0.13; p=0.018). Vascularity was the only significant predictor of air trapping (R2=0.24; p=0.001), which was validated in the replication group (R2=0.19; p=0.031).

In asthma, airway smooth muscle content and vascularity were both associated with airflow obstruction. QCT-derived proximal airway morphometry was most strongly associated with epithelial thickness and airway smooth muscle content, whereas air trapping was related to vascularity.

Abstract

Airway remodelling in asthma biopsies is associated with proximal airway QCT-derived morphometry and air trappinghttp://ow.ly/ucoA308Jv9F

Footnotes

Support statement: This work was part funded by Wellcome Trust Senior Fellowship (C.E. Brightling), Airway Disease Predicting Outcomes through Patient Specific Computational Modelling (AirPROM) project (funded through FP7 EU grant), Leicester National Institute for Health Research (NIHR) Respiratory Biomedical Research Unit, Novartis and GlaxoSmithKline (GSK). Some of the biopsy and computed tomography data mentioned here were baseline data for a proportion of patients who were enrolled into a phase II randomised controlled trial (QAW039A2208) that was sponsored by Novartis Pharmaceuticals. S. Gupta is a NIHR Clinical Lecturer and is funded by a research and career development training scheme. This paper presents independent research funded by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Dept of Health. Funding information for this article has been deposited with the Open Funder Registry.

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